AR Follow-Up Specialist III - Coding and Complex Denials #Full Time #Remote
$59,738–$76,794 year
Hybrid · New York, United States or Connecticut, United States
Job Summary
AR Follow-Up Specialist III focusing on coding and complex denials, and follow-up on unpaid claims with insurance companies. Collaborates closely with Certified Professional Coders (CPCs) to gather documentation, support appeals, and overturn coding-related denials; escalate advanced cases to CPCs or supervisors. Prepare and submit appeals for denied claims, including Letters of Medical Necessity and supporting documentation. Address incoming correspondence related to coding denials and respond promptly. Identify patterns in coding-related denials to inform process improvements. Provide input on denial-management best practices and assist in training new hires on coding and denial workflows. Contact insurance companies, patients, or account guarantors to obtain status of outstanding claims and submitted appeals; perform demographic and insurance updates; address issues related to third-party sponsorship. Assist the unit supervisor/manager with monitoring work queues and other assigned duties. The role supports ColumbiaDoctors within a remote-capable framework with occasional in-person training/meetings in the Tri-State area.
Required Qualifications
- High school graduate or GED
- 2 years of physician billing or third party payer experience
- ability to understand contracts, insurance benefits, exclusions, and payer rules
- communication skills (verbal and written)
- intermediate computer skills (Word, Excel, Outlook)
- experience with Epic or other electronic billing systems preferred
- knowledge of medical terminology, diagnosis, procedures coding preferred
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